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Int J Radiat Oncol Biol Phys 2017[Mar]; 97 (3): 624-37 PMID28126309show ga
Radiotherapy is a crucial component of cancer care, employed in the treatment of over 50% of cancer patients. Patients undergoing image-guided radiotherapy or brachytherapy routinely have inert radiotherapy (RT) biomaterials implanted into their tumors. The single function of these RT biomaterials is to ensure geometric accuracy during treatment. Recent studies have proposed that the inert biomaterials could be upgraded to ?smart? RT biomaterials, designed to do more than one function. Such smart biomaterials include next generation fiducial markers, brachytherapy spacers, and balloon applicators, designed to respond to stimulus and perform additional desirable functions like controlled delivery of therapy-enhancing payloads directly into the tumor sub-volume, while minimizing normal tissue toxicities. More broadly, smart RT biomaterials may include functionalized nanoparticles that can be activated to boost radiotherapy efficacy. This work reviews the rationale for smart radiotherapy biomaterials, the state-of-the-art in this emerging cross-disciplinary research area, challenges/opportunities for further research and development, and a purview of potential clinical applications. Applications covered include using smart RT biomaterials for boosting cancer therapy with minimal side effects, combining radiotherapy with immunotherapy or chemotherapy, reducing treatment time or healthcare costs, and other incipient applications.